Bisphosphonates in Treatment of Complex Regional Pain Syndrome, continued

08/13/2014 — Nancy Sajben MD

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A new publication out of Germany, May 2014, in the journal Pain, suggests a strong rationale for the use of bisphosphonates in the treatment of Complex Regional Pain Syndrome (CRPS). See my reviewof those infusions..\

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Impaired bone metabolism is a feature of CRPS.

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They found evidence that osteoprotegerin (OPG) was elevated in serum of persons with CRPS. That is not unique to CRPS, but it might be useful as a potential biomarker for CRPS. It is also increased with osteoporosis, coronary heart failure, irritable bowel syndrome, and is it associated with long term renal dysfunction.

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OPG is an inhibitor of osteoclast formation, important for bone remodeling and it may contribute to CRPS pathophysiology.

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They compared OPG with triple phase bone scan (TPBS).

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For the CRPS-affected hand, a significant correlation between OPG and TPBS region of interest analysis in phase III was detected. The persistent OPG increase in CRPS indicates enhanced osteoblastic activity shown by increased radiotracer uptake in TPBS phase III. A contribution of bone turnover to CRPS pathophysiology is likely. OPG might be useful as a biomarker for CRPS.

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